The objective of this section is to ensure that when the decision does have to be considered the full range of options is known and the consequences understood.

There is a graded level of support, both in terms of help in the present home and that when moving into other forms of residential accommodation. The descriptions given below are brief but by using the hyperlinks provide a fuller description of all forms of care will be shown.

Home Support - Non-residential support

• Care at home in the form of assistance with personal care, domestic needs, shopping and money matters.
• Meals on Wheels
• Night Sitting Services
• Community Alarm support
• Day Care provision in the form of lunch clubs and group activities
• Laundry Services
• Local retailer prepared meals

The financial costs and assessment of what the client will have to pay is considered under the section on access to finance.

Accommodation Support
The provision can be categorised as follows:

• Amenity house
  Offering self-contained accommodation with the minimal level of on-site support. There is likely to be an alarm system supported by an off site control room. It is very unlikely that there will be any warden provision. This form of home is provided in both the rented and private sector. In the latter there are specific companies who have specialised in the building of such facilities.
• Sheltered housing
  A range of organisation may provide these for rent. The feature of them is the communal provision of lounge and support facilities, the organisation of communal social activities and the provision of a live in warden.

• Very sheltered housing/Supported accommodation
  In these houses there is still the provision of private accommodation in the form of a room and private facilities, but here the staff will provide more of the catering provision and general support.
• Residential Care
  Residential care offers 24 hour care for residents who are needing greater support to that which is possible in the above categories. These homes are subject to a Needs Assessment unless the individual is able to pay the full costs out of their own resources. This type of care however does not provide professional nursing support.
• Nursing Homes
  In these establishments 24 hour professional nursing care is provided on top of the residential support that would be found in the category described above. As with the residential care, unless you are able to meet the full cost directly the entry to this form of accommodation is based on assessment, this includes a medical assessment of nursing needs.

• Dual Function
  These are homes where both residential and nursing care can be offered to the clients. The advantage of this form of home is that unlike a purely residential home, the client will not need to be moved if the nursing needs are found to be required at a later date.
• NHS Continuing Care
  A person only qualifies for this form of support, funded by the NHS, if the ongoing 24 hour nursing support needs the additional input of a medical consultant.
• Respite Care
  This form of support is on a temporary basis and may be provided in residential, nursing and hospital environments. The provision is to care for the client as they and their carer have a break from caring in the home.

In cases where the level of support required is more extensive the selection options are more restricted and often subject to professional assessment. Even where the category of support is clearly defined there will still exist a selection decision on which provider will fulfil the need, and in the selection check list there are some basic questions that you should use prior to making a final decision on the service provider.

It is also important to note that the area where the care provision is delivered need not be in the same council area as the current Social Work Department. In these circumstances there is a need to check that the selected provider can and will work to the social work contract that is in force in the assessing area. Consideration also needs to be made to the care costs in relation to the Social Work standard contract cost, and to determine how any shortfall will be met. (this being considered in the fee differential section)

Consideration should also be given to the Charitable and Benevolent Fund care providers and to determine whether the client may meet their qualifying entry criteria.

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